Most medical personnel probably advise new mothers to breastfeed their babies. Alexandra Sifferlin wrote in the Time article, Why New Mothers Stop Breast-Feeding:

While nearly all mothers start breast-feeding their newborns, about half stop after a few weeks. The latest study explains why.
A team of researchers conducted over 2,700 interviews with 532 first-time mothers multiple times after they gave birth, starting 24 hours after delivery and ending at 60 days postpartum, about their breast-feeding choices. They report in the journal Pediatrics that women who worried from the start about their ability to nurse their infants were more likely to switch to formula sooner than those who didn’t have these concerns.
By the third day after delivering, over half of these women were worried about their babies’ ability to latch on, while 44% were concerned about breast-feeding pain, and 40% about their capacity to produce enough milk to nourish their infants.
These results support earlier studies that found that new moms often don’t have proper support and education about breast-feeding, which can lead to anxiety and a greater likelihood of stopping nursing. In January, TIME reported that hospitals may not offer women the resources they need to encourage women and address their anxiety…http://healthland.time.com/2013/09/23/why-new-mothers-stop-breastfeeding/

UNICEF Mozambique has a concise statement regarding the benefits of breastfeeding:

Breastmilk alone is the best food and drink for an infant for the first six months of life. No other food or drink, not even water, is usually needed during this period. http://www.factsforlifeglobal.org/04/1.html 2. Newborn babies should be given to the mother to hold immediately after delivery. They should have skin-to-skin contact with the mother and begin breastfeeding within one hour of birth. http://www.factsforlifeglobal.org/04/2.html 3. Almost every mother can breastfeed successfully. Breastfeeding the baby frequently causes production of more milk. The baby should breastfeed at least eight times daily, day and night, and on demand. http://www.factsforlifeglobal.org/04/3.html 4. Breastfeeding helps protect babies and young children against dangerous illnesses. It also creates a special bond between mother and child. http://www.factsforlifeglobal.org/04/4.html 5. Bottle feeding and giving a baby breastmilk substitutes such as infant formula or animal milk can threaten the baby’s health and survival. If a woman cannot breastfeed her infant, the baby can be fed expressed breastmilk or, if necessary, a quality breastmilk substitute from an ordinary clean cup. http://www.factsforlifeglobal.org/04/5.html 6. If a woman is infected with HIV, there is a risk that she can pass the infection to her infant through breastfeeding. In the first six months, this risk is much greater if the infant is fed both breastmilk and other liquids and foods than if fed breastmilk alone. Therefore, it is recommended that the baby receives breastmilk alone for the first six months, unless it is acceptable, feasible, affordable, sustainable and safe to give breastmilk substitutes (infant formula) exclusively. http://www.factsforlifeglobal.org/04/6.html 7. A woman employed away from her home can continue to breastfeed her child. She should breastfeed as often as possible when she is with the infant and express her breastmilk when they are apart so that another caregiver can feed it to the baby in a clean and safe way. http://www.factsforlifeglobal.org/04/7.html 8. After 6 months of age, when babies begin to eat foods, breastfeeding should continue for up to two years and beyond because it is an important source of nutrition, energy and protection from illness. http://www.factsforlifeglobal.org/04/8.html For more information, please contact: Arild Drivdal, UNICEF Mozambique, tel. (+258) 21 481 100; email: maputo@unicef.org Gabriel Pereira, UNICEF Mozambique, tel. (+258) 21 481 100; email: maputo@unicef.org http://www.unicef.org/mozambique/media_9256.html

A new study, which followed 180 pre-term infants from birth to age seven, found that babies who were fed more breast milk within the first 28 days of life had had larger volumes of certain regions of the brain at term equivalent and had better IQs, academic achievement, working memory, and motor function.

The findings were published online in The Journal of Pediatrics.

“Our data support current recommendations for using mother’s milk to feed preterm babies during their neonatal intensive care unit (NICU) hospitalization. This is not only important for moms, but also for hospitals, employers, and friends and family members, so that they can provide the support that’s needed during this time when mothers are under stress and working so hard to produce milk for their babies,” says Mandy Brown Belfort, MD, a researcher and physician in the Department of Newborn Medicine at Brigham and Women’s Hospital and lead author.

Researchers studied infants born before 30 weeks gestation that were enrolled in the Victorian Infant Brain Studies cohort from 2001-2003. They determined the number of days that infants received breast milk as more than 50 percent of of their nutritional intake from birth to 28 days of life. Additionally, researchers examined data related to regional brain volumes measured by magnetic resonance imaging (MRI) at each baby’s term equivalent age and at seven years old, and also looked at cognitive (IQ, reading, mathematics, attention, working memory, language, visual perception) and motor testing at age seven.

The findings show that, accross all babies, infants who received predominantly breast milk on more days during their NICU hospitalization had larger deep nuclear gray matter volume, an area important for processing and transmitting neural signals to other parts of the brain, at term equivalent age, and by age seven, performed better in IQ, mathematics, working memory, and motor function tests. Overall, ingesting more human milk correlated with better outcomes, including larger regional brain volumes at term equivalent and improved cognitive outcomes at age 7…. https://www.sciencedaily.com/releases/2016/07/160729092524.htm

A new study, which followed 180 pre-term infants from birth to age seven, found that babies who were fed more breast milk within the first 28 days of life had had larger volumes of certain regions of the brain at term equivalent and had better IQs, academic achievement, working memory, and motor function.

A new study, which followed 180 pre-term infants from birth to age seven, found that babies who were fed more breast milk within the first 28 days of life had had larger volumes of certain regions of the brain at term equivalent and had better IQs, academic achievement, working memory, and motor function.

The findings were published online Friday, July 29, in The Journal of Pediatrics.

“Our data support current recommendations for using mother’s milk to feed preterm babies during their neonatal intensive care unit (NICU) hospitalization. This is not only important for moms, but also for hospitals, employers, and friends and family members, so that they can provide the support that’s needed during this time when mothers are under stress and working so hard to produce milk for their babies,” says Mandy Brown Belfort, MD, a researcher and physician in the Department of Newborn Medicine at Brigham and Women’s Hospital and lead author.

Researchers studied infants born before 30 weeks gestation that were enrolled in the Victorian Infant Brain Studies cohort from 2001-2003. They determined the number of days that infants received breast milk as more than 50 percent of of their nutritional intake from birth to 28 days of life. Additionally, researchers examined data related to regional brain volumes measured by magnetic resonance imaging (MRI) at each baby’s term equivalent age and at seven years old, and also looked at cognitive (IQ, reading, mathematics, attention, working memory, language, visual perception) and motor testing at age seven.

The findings show that, accross all babies, infants who received predominantly breast milk on more days during their NICU hospitalization had larger deep nuclear gray matter volume, an area important for processing and transmitting neural signals to other parts of the brain, at term equivalent age, and by age seven, performed better in IQ, mathematics, working memory, and motor function tests. Overall, ingesting more human milk correlated with better outcomes, including larger regional brain volumes at term equivalent and improved cognitive outcomes at age 7.

“Many mothers of preterm babies have difficulty providing breast milk for their babies, and we need to work hard to ensure that these mothers have the best possible support systems in place to maximize their ability to meet their own feeding goals. It’s also important to note that there are so many factors that influence a baby’s development, with breast milk being just one,” says Belfort.

Researchers note some limitations on the study, including that it was observational. Although they adjusted for factors such as differences in maternal education, some of the effects could possibly be explained by other factors that were not measured, such as greater maternal involvement in other aspects of infant care.

Belfort adds that future studies using other MRI techniques could provide more information about the specific ways in which human milk intake may influence the structure and function of the brain. Future work is also needed to untangle the role of breastfeeding from other types of maternal care and nurturing on development of the preterm baby’s brain.

There are disadvantages for bottle fed babies. The University of Wisconsin Health Center succinctly discussed the disadvantages of bottle feeding in Bottle-Feeding: Disadvantages for Babies:

Bottle-Feeding: Disadvantages for Babies
Topic Overview
Infant formulas take two times longer for a baby to digest than breast milk. The slower digestion of infant formula can affect:
Feeding frequency. Babies who take infant formula usually want to feed less often than babies who are breast-feeding.
Sleeping patterns. Babies who take infant formula may sleep longer at night once they are about 2 months old. But babies who are breast-fed usually catch up shortly after, at about 3 to 5 months of age.
Bowel movements. Infant formula causes formed, brown stools that have a noticeable odor. Breast milk causes loose, yellow stools that have less odor.
Breast milk, unlike formula, has antibodiesClick here to see more information.. Breast-feeding may lower your child’s risk for many types of infections and allergies. Breast milk may also help protect your child from some health problems, such as eczema, asthma, and diabetes. For more information, see the topic Breast-Feeding.
Related Information
Last Revised: August 1, 2011
Author: Healthwise Staff
Medical Review: John Pope, MD – Pediatrics & Thomas Emmett Francoeur, MD, MDCM, CSPQ, FRCPC – Pediatricshttp://www.uwhealth.org/health/topic/special/bottlefeeding-disadvantages-for-babies/tj8029.html

Formula-fed babies may grow too quickly and may be more susceptible than breastfed babies to obesity and other chronic diseases later in life, a new study says.
Five formula-fed baby rhesus monkeys grew faster and larger than five breastfed rhesus monkey babies, and had higher insulin levels after just one week, lead study author Carolyn Slupsky, a researcher at University of California, Davis, told The Huffington Post. The study was funded by Fonterra Research and Development Centre, an arm of the New Zealand-based global dairy giant, which makes baby formula, and was published in the June issue of Journal of Proteome Research.
“This is the fist time somebody has glimpsed into the mechanism of what’s going on with formula,” Slupsky said. The results, she said, should be “a call to arms to the formula companies to come up with better formulas that are going to ensure the health of our future population.”
The UC Davis researchers closely monitored the monkey babies’ weight and feeding, and took weekly blood and urine samples for three months.
In addition to having higher insulin and amino acid levels, the formula-fed babies had microbes in their digestive tracts that were “completely different” than those in the breastfed babies, the study says. This may put formula-fed babies at a higher risk of a wide range of health issues, such as obesity, diabetes, liver problems and cardiovascular disease, Slupsky said.
Part of the difference may be explained by an excess of protein in formula milk. Human milk is 8 percent to 9 percent protein, and rhesus monkey milk is 11.6 percent protein. But formula has 18.3 percent protein. “The quality of protein in formula is not the same as in human milk, so formula companies decided to add more of it to make up for any deficits,” Slupsky explained. “But that may be problematic.”
A study in 2010 suggested that parents may overfeed bottle-fed babies, while breastfed babies limit their intake because they have to work hard to get it. Slupsky said she does not think that was a factor in her study because the formula-fed baby monkeys fed themselves by sucking on a bottle when they were hungry.
Slupsky said researchers at UC Davis are working with formula companies to create formula that more closely resembles human breast milk.http://www.huffingtonpost.com/2013/08/12/baby-formula-disease-study_n_3728706.html

One of the most effective ways to combat poverty among current and future generations is to maintain a full employment economy. The point should be straightforward: when the labor market is strong, or “tight,” it offers increased employment opportunities for those at the bottom. Disadvantaged workers are not only more likely to find employment in a tight labor market, they are also in a better position to secure higher wages as employers are forced to compete for labor. This can allow millions of workers the opportunity to raise themselves and their families out of poverty…. http://www.truth-out.org/news/item/35279-how-to-fight-poverty-through-full-employment

Science Daily reported in Transit and training crucial to connecting unemployed with jobs:

According to a new University of Minnesota study, the mismatch between unemployed workers and job vacancies is a serious problem in the Twin Cities region and it appears to have worsened since the turn of the millennium. The biggest concentrations of unemployed workers lack fast or frequent transit service to some of the richest concentrations of job vacancies, particularly vacancies in the south and southwest metro.

The new study analyzes such employment mismatches in the Twin Cities seven-county metropolitan area and examines the potential of a new approach that integrates transit planning and workforce development.

“Transit plays a crucial role in connecting the unemployed with job opportunities, but it could be even more effective if efforts to get the unemployed to those job vacancies were better coordinated with efforts to give them the skills they need for those job vacancies,” said principal investigator Yingling Fan, who conducted the study with research fellow Andrew Guthrie. “Our research lays out an approach to reconcile those mismatches by coordinating transit planning, job training and job placement services.”

Disadvantaged job seekers often may be qualified for many entry-level jobs but have no way of reaching employment centers, which frequently are in the suburbs. What’s more, these job seekers may be able to reach many nearby jobs easily but lack needed qualifications…. https://www.sciencedaily.com/releases/2016/07/160729111302.htm

Citation:

Transit and training crucial to connecting unemployed with jobs

Date: July 29, 2016

Source: University of Minnesota

Summary:

The mismatch between unemployed workers and job vacancies is a serious problem in the Twin Cities region and it appears to have worsened since the turn of the millennium, new research indicates. The biggest concentrations of unemployed workers lack fast or frequent transit service to some of the richest concentrations of job vacancies, particularly vacancies in the south and southwest metro.

Here is the press release from the University of Minnesota:

Transit and training crucial to connecting unemployed with jobs

Transit and training crucial to connecting Twin Cities unemployed with job opportunities. Disadvantaged job seekers often may be qualified for many entry-level jobs but have no way of reaching employment centers, which frequently are in the suburbs. What’s more, these job seekers may be able to reach many nearby jobs easily but lack needed qualifications.

According to a new University of Minnesota study, the mismatch between unemployed workers and job vacancies is a serious problem in the Twin Cities region and it appears to have worsened since the turn of the millennium. The biggest concentrations of unemployed workers lack fast or frequent transit service to some of the richest concentrations of job vacancies, particularly vacancies in the south and southwest metro.

The new study analyzes such employment mismatches in the Twin Cities seven-county metropolitan area and examines the potential of a new approach that integrates transit planning and workforce development.

“Transit plays a crucial role in connecting the unemployed with job opportunities, but it could be even more effective if efforts to get the unemployed to those job vacancies were better coordinated with efforts to give them the skills they need for those job vacancies,” said principal investigator Yingling Fan, who conducted the study with research fellow Andrew Guthrie. “Our research lays out an approach to reconcile those mismatches by coordinating transit planning, job training and job placement services.”

Disadvantaged job seekers often may be qualified for many entry-level jobs but have no way of reaching employment centers, which frequently are in the suburbs. What’s more, these job seekers may be able to reach many nearby jobs easily but lack needed qualifications.

Efforts to address these mismatches often focus on transportation—such as improved or specialized public transit services—and skill-building and occupational training programs. Policymakers have generally separated the two.

“The Twin Cities region is in the midst of major expansion of the transit system and it will have consequences in terms of travel patterns and development patterns for decades,” Fan said. “That allows coordinated job training and transit planning efforts to make a big, long-lasting impact.”

The research team’s policy recommendations center on finding “sweet spots” for coordinated transit planning and workforce development and creating a future transit system to serve the needs of disadvantaged workers.

A key element of the study involves GIS maps developed by the researchers showing the concentrations of the unemployed, overlaid with patterns of job vacancies, for the entire region, between 2001 and 2013. They compared transit-accessible job vacancies for specific occupations to determine mismatch patterns.

For example, a band of cities with the highest job vacancies in manufacturing—jobs that have comparatively lower educational requirements—surround Minneapolis to the west and north. The highest concentrations of unemployment, however, are in Minneapolis and St. Paul.

The team then developed multiple transit planning, job creation, and workforce development policy scenarios, generating similar maps for each.

The study was sponsored by Hennepin County, the Jay and Rose Phillips Family Foundation of Minnesota, and the McKnight Foundation.

“McKnight Foundation focuses on our low-income people and places that have been left out of the picture previously. Dr. Fan’s research pulls these areas together so policy-makers can see how policy can connect, reinforce, support, and provide benefit to the people that we care about,” said Eric Muschler, program director with the McKnight Foundation.

Fan, an associate professor with the University of Minnesota Humphrey School of Public Affairs, collaborates with the Center for Transportation Studies as a faculty scholar. CTS is nationally renown for developing, fostering, and spreading innovation in transportation.

Some in society are pushing the concept of gender-neutral. Alina Tugend wrote Engendering Sons: Is It Doable—or Even Desirable—to Raise Gender-Neutral Children?

Overcoming gender disparities may require us to take a more nuanced approach to problem solving. For example, if we want more girls and women, who are now woefully underrepresented, to take more science, technology, engineering, and math classes, and we agree that it’s not innate ability holding them back, the answer might be to show scientists, engineers, and mathematicians to be attractive and caring rather than nerdy. Or change the physical environment of classrooms and laboratories to make them more appealing to girls.

Then again, does this counter or reinforce gender stereotypes? Good people disagree.

One thing that’s easy to forget, as Janet Hyde points out, is that variations within genders are greater than variations between them. I see the truth of that in my own home. Both my boys are into sports, but one is far more talkative and intellectually curious, while the other ranks higher on intuition and emotional intelligence. If they were a boy and a girl, it would be easy to attribute these differences to gender. As it is, I guess I’ll have to blame—or credit—the vast and ever-shifting mishmash of biology, parenting, peer influence, and culture. http://alumni.berkeley.edu/california-magazine/winter-2014-gender-assumptions/engendering-sons-it-doable-or-even-desirable

One study points to the idea that gender concept starts early.

Science Daily reported in Infants prefer toys typed to their gender:

Children as young as 9 months-old prefer to play with toys specific to their own gender, according to a new study from academics at City University London and UCL.

The paper, which is published in the journal of Infant and Child Development, shows that in a familiar nursery environment significant sex differences were evident at an earlier age than gendered identity is usually demonstrated.

The research therefore suggests the possibility that boys and girls follow different developmental trajectories with respect to selection of gender-typed toys and that there is both a biological and a developmental-environmental components to the sex differences seen in object preferences.

To investigate the gender preferences seen with toys, the researchers observed the toy preferences of boys and girls engaged in independent play in UK nurseries, without the presence of a parent. The toys used in the study were a doll, a pink teddy bear and a cooking pot for girls, while for boys a car, a blue teddy, a digger and a ball were used.

The 101 boys and girls fell into three age groups: 9 to 17 months, when infants can first demonstrate toy preferences in independent play (N=40); 18 to 23 months, when critical advances in gender knowledge occur (N=29); and 24 to 32 months, when knowledge becomes further established (N=32).

Stereotypical toy preferences were found for boys and girls in each of the age groups, demonstrating that sex differences in toy preference appear early in development. Both boys and girls showed a trend for an increasing preference with age for toys stereotyped for boys….

“Our results show that there are significant sex differences across all three age groups, with the finding that children in the youngest group, who were aged between 9-17months when infants are able to crawl or walk and therefore make independent selections, being particularly interesting; the ball was a favourite choice for the youngest boys and the youngest girls favoured the cooking pot.” https://www.sciencedaily.com/releases/2016/07/160715114739.htm

Citation:

Infants prefer toys typed to their gender, says study

Date: July 15, 2016

Source: City University

Summary:

Children as young as 9 months-old prefer to play with toys specific to their own gender, according to a new study. The research suggests the possibility that boys and girls follow different developmental trajectories with respect to selection of gender-typed toys and that there is both a biological and a developmental-environmental components to the sex differences seen in object preferences.

Research suggests the possibility that boys and girls follow different developmental trajectories with respect to selection of gender-typed toys

Children as young as 9 months-old prefer to play with toys specific to their own gender, according to a new study from academics at City University London and UCL.

The paper, which is published in the journal of Infant and Child Development, shows that in a familiar nursery environment significant sex differences were evident at an earlier age than gendered identity is usually demonstrated.

The research therefore suggests the possibility that boys and girls follow different developmental trajectories with respect to selection of gender-typed toys and that there is both a biological and a developmental-environmental components to the sex differences seen in object preferences.

To investigate the gender preferences seen with toys, the researchers observed the toy preferences of boys and girls engaged in independent play in UK nurseries, without the presence of a parent. The toys used in the study were a doll, a pink teddy bear and a cooking pot for girls, while for boys a car, a blue teddy, a digger and a ball were used.

The 101 boys and girls fell into three age groups: 9 to 17 months, when infants can first demonstrate toy preferences in independent play (N=40); 18 to 23 months, when critical advances in gender knowledge occur (N=29); and 24 to 32 months, when knowledge becomes further established (N=32).

Stereotypical toy preferences were found for boys and girls in each of the age groups, demonstrating that sex differences in toy preference appear early in development. Both boys and girls showed a trend for an increasing preference with age for toys stereotyped for boys.

Speaking about the study, Dr Brenda Todd, a senior lecturer in psychology at City University said:

“Sex differences in play and toy choice are of interest in relation to child care, educational practice and developmental theory. Historically there has been uncertainty about the origins of boys’ and girls’ preferences for play with toys typed to their own sex and the developmental processes that underlie this behaviour. As a result we set out to find out whether a preference occurs and at what age it develops.

“Biological differences give boys an aptitude for mental rotation and more interest and ability in spatial processing, while girls are more interested in looking at faces and better at fine motor skills and manipulating objects. When we studied toy preference in a familiar nursery setting with parents absent, the differences we saw were consistent with these aptitudes. Although there was variability between individual children, we found that, in general, boys played with male-typed toys more than female-typed toys and girls played with female-typed toys more than male-typed toys.

“Our results show that there are significant sex differences across all three age groups, with the finding that children in the youngest group, who were aged between 9–17 months when infants are able to crawl or walk and therefore make independent selections, being particularly interesting; the ball was a favourite choice for the youngest boys and the youngest girls favoured the cooking pot.”

Melanie Phillips of the Spectator wrote in It’s dangerous and wrong to tell all children they’re ‘gender fluid’:

In short, the political class is obsessed by gender issues. I trust you are, too. Surely you can reel off the differences between trans, intersex, polygender, asexual, gender–neutral and genderqueer? Do keep up. We’re all gender fluid now, no?

No. Gender is not fluid. What is fluid, however, is the language.

The notion that gender can be deconstructed in accordance with ideology started in the 1970s when (ironically, in view of the Greer row) it was promoted by feminists for whom gender was not a biological fact but a social construct. But it’s not. Gender derives from a complex relationship between biological sex and behaviour. And nature and nurture are not easily separable. Some unfortunates feel they are trapped in the wrong gender. Surgery may or may not resolve this confusion. Many who change sex still don’t feel comfortable; tragically, some even commit suicide.

Crucially, however, such people are desperate to make that change. That’s because for trans people gender is certainly not irrelevant but is of all–consuming importance. Yet Miller and her committee would deprive them of the ability to announce their new sexual identity on passports or other official documents.

Research from Dr. Shonkoff’s center and from other experts finds that positive stress—the kind that comes from telling a toddler he can’t have a cookie or a teenager that she’s about to take a pop quiz—causes a brief rise in heart rate and stress hormones. A jolt can focus a student’s attention and is generally considered healthy.

Similarly, a child can tolerate stress that is severe but may be relatively short-term—from the death of a loved one, for example—as long as he or she has support….

‘Toxic’ Recipe

By contrast, so-called “toxic stress” is severe, sustained, and not buffered by supportive relationships.

A new study on infantile memory formation in rats points to the importance of critical periods in early-life learning on functional development of the brain. The research, conducted by scientists at New York University’s Center for Neural Science, reveals the significance of learning experiences over the first two to four years of human life; this is when memories are believed to be quickly forgotten — a phenomenon known as infantile amnesia.

“What our findings tell us is that children’s brains need to get enough and healthy activation even before they enter pre-school,” explains Cristina Alberini, a professor in NYU’s Center for Neural Science, who led the study. “Without this, the neurological system runs the risk of not properly developing learning and memory functions…”

In their study, which appears in the journal Nature Neuroscience, the researchers examined the mechanisms of infantile memory in rats — i.e., memories created 17 days after birth. This is the equivalent of humans under the age of three and when memories of who, what, when, and where — known as episodic memories — are rapidly forgotten. The phenomenon, referred as to “infantile or childhood amnesia,” is in fact the inability of adults to retrieve episodic memories that took place during the first two to four years of life.

In addressing this matter, Alberini and her colleagues compared rats’ infantile memory with that when they reached 24 days old — that is, when they are capable of forming and retaining long-term memories and at an age that roughly corresponds to humans at six to nine years old.

The episodic memory tested in the rodents was the memory of an aversive experience: a mild foot shock received upon entering in a new place. Adult rats, like humans, remember unpleasant or painful experiences that they had in specific places, and then avoid returning to them.

To do so, rodents were placed in a box divided into two compartments: a “safe” compartment and a “shock” compartment. During the experiment, each rat was placed in the safe compartment with its head facing away from the door. After 10 seconds, the door separating the compartments was automatically opened, allowing the rat access to the shock compartment. If the rat entered the shock compartment, it received a mild foot shock.

The first set of results was not surprising. The authors found infantile amnesia for the 17 day-old rats, which showed avoidance of the “shock” compartment right after the experience, but lost this memory very rapidly: a day later these rats quickly returned to this compartment. In contrast, the rats exposed to the shock compartment at 24 days of life learned and retained the memory for a long time and avoided this place — revealing a memory similar to that of adult rats.

However, remarkably, the younger rats, which had apparently forgotten the initial experience, subsequently showed they actually had kept a trace of the memory. When, later in life, these rats were prompted with reminders — i.e., they were presented with recollections of the context and the foot shock — they indicated having a specific memory, which was revealed by their avoidance of the specific context in which they received a shock at day 17 of life. These findings show how early life experience, although not expressed or remembered, can influence adult life behavior.

The findings raised the following question: what is occurring — neurologically — that explains why memories are retained by the younger rats only in a latent form but are stored and expressed long-term by older ones? Or, more specifically, what occurs during development that enhances the ability to form lasting memories?

A critical period is a developmental stage during which the nervous system is especially sensitive to environmental stimuli. If, during this period, the organism does not receive the appropriate stimuli required to develop a given function, it may be difficult or even impossible to develop that function later in life. Well-known examples of critical period-based functions are sensory functions, like vision, and language acquisition.

Infantile memory study points to critical periods in early-life learning for brain development

Date: July 18, 2016

Source: New York University

Summary:

A new study on infantile memory formation in rats points to the importance of critical periods in early-life learning on functional development of the brain. The research reveals the significance of learning experiences over the first two to four years of human life.

Infantile Memory Study Points to Critical Periods in Early-Life Learning for Brain Development

July 18, 2016

A new study on infantile memory formation in rats points to the importance of critical periods in early-life learning on functional development of the brain. The research, conducted by scientists at New York University’s Center for Neural Science, reveals the significance of learning experiences over the first two to four years of human life; this is when memories are believed to be quickly forgotten—a phenomenon known as infantile amnesia.

“What our findings tell us is that children’s brains need to get enough and healthy activation even before they enter pre-school,” explains Cristina Alberini, a professor in NYU’s Center for Neural Science, who led the study. “Without this, the neurological system runs the risk of not properly developing learning and memory functions.”

The other authors of the study, conducted in collaboration with the Icahn School of Medicine at Mt. Sinai, included: Alessio Travaglia, a post-doctoral researcher at NYU; Reto Bisaz, an NYU research scientist at the time of the study; Eric Sweet, a post-doctoral fellow at the Icahn School of Medicine at Mt. Sinai; and Robert Blitzer, a professor at the Icahn School of Medicine at Mt. Sinai.

In their study, which appears in the journal Nature Neuroscience, the researchers examined the mechanisms of infantile memory in rats—i.e., memories created 17 days after birth. This is the equivalent of humans under the age of three and when memories of who, what, when, and where–known as episodic memories–are rapidly forgotten. The phenomenon, referred as to “infantile or childhood amnesia,” is in fact the inability of adults to retrieve episodic memories that took place during the first two to four years of life.

In addressing this matter, Alberini and her colleagues compared rats’ infantile memory with that when they reached 24 days old—that is, when they are capable of forming and retaining long-term memories and at an age that roughly corresponds to humans at six to nine years old.

The episodic memory tested in the rodents was the memory of an aversive experience: a mild foot shock received upon entering in a new place. Adult rats, like humans, remember unpleasant or painful experiences that they had in specific places, and then avoid returning to them.

To do so, rodents were placed in a box divided into two compartments: a “safe” compartment and a “shock” compartment. During the experiment, each rat was placed in the safe compartment with its head facing away from the door. After 10 seconds, the door separating the compartments was automatically opened, allowing the rat access to the shock compartment. If the rat entered the shock compartment, it received a mild foot shock.

The first set of results was not surprising. The authors found infantile amnesia for the 17 day-old rats, which showed avoidance of the “shock” compartment right after the experience, but lost this memory very rapidly: a day later these rats quickly returned to this compartment. In contrast, the rats exposed to the shock compartment at 24 days of life learned and retained the memory for a long time and avoided this place—revealing a memory similar to that of adult rats.

However, remarkably, the younger rats, which had apparently forgotten the initial experience, subsequently showed they actually had kept a trace of the memory. When, later in life, these rats were prompted with reminders—i.e., they were presented with recollections of the context and the foot shock—they indicated having a specific memory, which was revealed by their avoidance of the specific context in which they received a shock at day 17 of life. These findings show how early life experience, although not expressed or remembered, can influence adult life behavior.

The findings raised the following question: what is occurring—neurologically—that explains why memories are retained by the younger rats only in a latent form but are stored and expressed long-term by older ones? Or, more specifically, what occurs during development that enhances the ability to form lasting memories?

To address this, the scientists focused on the brain’s hippocampus, which previous scholarship has shown is necessary for encoding new episodic memories. Here, in a series of experiments similar to the box tests, they found that if the hippocampus was inactive, the ability of younger rats to form latent memories and recall them later by reminders as they got older was diminished. They then found that mechanisms of “critical periods” are fundamental for establishing these infantile memories.

A critical period is a developmental stage during which the nervous system is especially sensitive to environmental stimuli. If, during this period, the organism does not receive the appropriate stimuli required to develop a given function, it may be difficult or even impossible to develop that function later in life. Well-known examples of critical period-based functions are sensory functions, like vision, and language acquisition.

The study shows that there is a critical period for episodic learning and that during this period the hippocampus learns to become able to efficiently process and store memories long-term.

“Early in life, while the brain cannot efficiently form long-term memories, it is ‘learning’ how to do so, making it possible to establish the abilities to memorize long-term,” explains Alberini. “However, the brain needs stimulation through learning so that it can get in the practice of memory formation—without these experiences, the ability of the neurological system to learn will be impaired.”

These studies, the researchers observe, suggest that using learning and environmental interventions during a critical period may significantly help to address learning disabilities.

The research was supported, in part, by grants from the National Institute of Mental Health (R01-MH074736, R01-NS072359), part of the National Institutes of Health, and the Geneva-based Agalma Foundation.

People are concerned about the effects of fat consumption on overall health. Rochelle Bilow wrote in the Bon Appétit article Is Butter Good for You? Or Bad? What Does Science Say?

It’s time we got to the bottom of things. It’s time to finally, once and for all (sorta), answer the question: What does science say about butter? We combed through a century and a half of scientific studies to find every claim, counter-claim, and counter-counter-claim made about this delicious fat—and its slightly less delicious cousin, margarine.

Tufts University researched the association between butter consumption and disease.

Science Daily reported in Little to no association between butter consumption, chronic disease or total mortality:

Butter consumption was only weakly associated with total mortality, not associated with cardiovascular disease, and slightly inversely associated (protective) with diabetes, according to a new epidemiological study which analyzed the association of butter consumption with chronic disease and all-cause mortality. This systematic review and meta-analysis, published in PLOS ONE, was led by Tufts scientists including Laura Pimpin, Ph.D., former postdoctoral fellow at the Friedman School of Nutrition Science and Policy at Tufts in Boston, and senior author Dariush Mozaffarian, M.D., Dr.P.H., dean of the School.

Based on a systematic review and search of multiple online academic and medical databases, the researchers identified nine eligible research studies including 15 country-specific cohorts representing 636,151 unique individuals with a total of 6.5 million person-years of follow-up. Over the total follow-up period, the combined group of studies included 28,271 deaths, 9,783 cases of cardiovascular disease, and 23,954 cases of new-onset type 2 diabetes. The researchers combined the nine studies into a meta-analysis of relative risk.

Butter consumption was standardized across all nine studies to 14 grams/day, which corresponds to one U.S. Department of Agriculture estimated serving of butter (or roughly one tablespoon). Overall, the average butter consumption across the nine studies ranged from roughly one-third of a serving per day to 3.2 servings per day. The study found mostly small or insignificant associations of each daily serving of butter with total mortality, cardiovascular disease, and diabetes.

“Even though people who eat more butter generally have worse diets and lifestyles, it seemed to be pretty neutral overall,” said Pimpin, now a data analyst in public health modelling for the UK Health Forum. “This suggests that butter may be a “middle-of-the-road” food: a more healthful choice than sugar or starch, such as the white bread or potato on which butter is commonly spread and which have been linked to higher risk of diabetes and cardiovascular disease; and a worse choice than many margarines and cooking oils — those rich in healthy fats such as soybean, canola, flaxseed, and extra virgin olive oils — which would likely lower risk compared with either butter or refined grains, starches, and sugars….” https://www.sciencedaily.com/releases/2016/06/160629145200.htm

Citation:

Little to no association between butter consumption, chronic disease or total mortality

Date: June 29, 2016

Source: Tufts University, Health Sciences Campus

Summary:

An epidemiological study analyzing the association of butter consumption with chronic disease and mortality finds that butter was only weakly associated with total mortality, not associated with heart disease, and slightly inversely associated (protective) with diabetes.

Is Butter Back? A Systematic Review and Meta-Analysis of Butter Consumption and Risk of Cardiovascular Disease, Diabetes, and Total Mortality.

Abstract

BACKGROUND:

Dietary guidelines recommend avoiding foods high in saturated fat. Yet, emerging evidence suggests cardiometabolic benefits of dairy products and dairy fat. Evidence on the role of butter, with high saturated dairy fat content, for total mortality, cardiovascular disease, and type 2 diabetes remains unclear. We aimed to systematically review and meta-analyze the association of butter consumption with all-cause mortality, cardiovascular disease, and diabetes in general populations.

CONCLUSIONS:

This systematic review and meta-analysis suggests relatively small or neutral overall associations of butter with mortality, CVD, and diabetes. These findings do not support a need for major emphasis in dietary guidelines on either increasing or decreasing butter consumption, in comparison to other better established dietary priorities; while also highlighting the need for additional investigation of health and metabolic effects of butter and dairy fat.

BOSTON—Butter consumption was only weakly associated with total mortality, not associated with cardiovascular disease, and slightly inversely associated (protective) with diabetes, according to a new epidemiological study which analyzed the association of butter consumption with chronic disease and all-cause mortality. This systematic review and meta-analysis, published in PLOS ONE, was led by Tufts scientists including Laura Pimpin, Ph.D., former postdoctoral fellow at the Friedman School of Nutrition Science and Policy at Tufts in Boston, and senior author Dariush Mozaffarian, M.D., Dr.P.H., dean of the School.

Based on a systematic review and search of multiple online academic and medical databases, the researchers identified 9 eligible research studies including 15 country-specific cohorts representing 636,151 unique individuals with a total of 6.5 million person-years of follow-up. Over the total follow-up period, the combined group of studies included 28,271 deaths, 9,783 cases of cardiovascular disease, and 23,954 cases of new-onset type 2 diabetes. The researchers combined the nine studies into a meta-analysis of relative risk.

Butter consumption was standardized across all nine studies to 14grams/day, which corresponds to one U.S. Department of Agriculture estimated serving of butter (or roughly one tablespoon). Overall, the average butter consumption across the nine studies ranged from roughly one-third of a serving per day to 3.2 servings per day. The study found mostly small or insignificant associations of each daily serving of butter with total mortality, cardiovascular disease, and diabetes.

“Even though people who eat more butter generally have worse diets and lifestyles, it seemed to be pretty neutral overall,” said Pimpin, now a data analyst in public health modelling for the UK Health Forum. “This suggests that butter may be a “middle-of-the-road” food: a more healthful choice than sugar or starch, such as the white bread or potato on which butter is commonly spread and which have been linked to higher risk of diabetes and cardiovascular disease; and a worse choice than many margarines and cooking oils – those rich in healthy fats such as soybean, canola, flaxseed, and extra virgin olive oils – which would likely lower risk compared with either butter or refined grains, starches, and sugars.”

“Overall, our results suggest that butter should neither be demonized nor considered “back” as a route to good health,” said Mozaffarian. “More research is needed to better understand the observed potential lower risk of diabetes, which has also been suggested in some other studies of dairy fat. This could be real, or due to other factors linked to eating butter – our study does not prove cause-and-effect.”

Additional authors of this study are Jason HY Wu, M.Sc., Ph.D., and Hila Haskelberg, Ph.D., both of The George Institute for Global Health, University of Sydney, Australia; and Liana Del Gobbo, Ph.D., formerly a postdoctoral fellow at the Friedman School and currently a research fellow in cardiovascular medicine at Stanford School of Medicine.

This work was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health, under award number 5R01HL085710. For conflicts of interest disclosure, please see the study.

About the Friedman School of Nutrition Science and Policy at Tufts University

The Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University is the only independent school of nutrition in the United States. The school’s eight degree programs – which focus on questions relating to nutrition and chronic diseases, molecular nutrition, agriculture and sustainability, food security, humanitarian assistance, public health nutrition, and food policy and economics – are renowned for the application of scientific research to national and international policy.

“A significant limitation of this review is that some of the prospective studies adjusted for difference in serum cholesterol at baseline as well as other aspects of diet, including a healthy eating index and the intake of monounsaturated and polyunsaturated fatty acids.

“However, the finding is not surprising as 14g butter per day would only be expected to change blood cholesterol level by 1% and this alone would have an imperceptible effect on risk of CVD.

“The studies were also unable to make any allowance for butter in processed foods such as cake and biscuits.

“There is some speculation in the discussion that butter may provide extra vitamin D. However, this is mistaken as butter is a poor source of vitamin D and it is margarine that is fortified with vitamin D.

“Generally, I agree with the review that it is the overall dietary pattern that matters rather than the intake of specific food items.”

“This study appears to add to the evidence that whilst many dairy products can be beneficial to health when consumed in moderation, higher fat products can mitigate this beneficial effect, so this certainly isn’t carte blanche to consume large amounts of butter. This study was normalised to a 14g per day intake (which is roughly an average intake) but other studies show a dose response indicating an increased risk with increased intake of high fat dairy products.

“As mentioned in the article, the consumption of many dairy products has been linked with a range of positive health benefits. The biggest effects are seen with lower fat dairy products, but some positive effects are also seen with cheese consumption. These products have a much lower fat content than butter, and it is thought that the positive health effects are linked to the water soluble compounds such as the vitamin, mineral and protein content. Butter on the other hand consists of about 80% milk fat, with only 20% water, so a lot of the protein, minerals etc. are lost. The fat is also high in saturated fat but does contain a fair amount of the fat soluble vitamins, especially vitamin A.

“Other studies have also shown that high fat dairy products give a small increase in risk of CVD, and are neutral in terms of total mortality, but lower fat content dairy products are linked to reduced risk overall. Other analyses also show some U shaped curves, with moderate consumption reducing risk, but higher levels of consumption could lead to an increased risk.

“Also, it is not clear how associated lifestyle affects this relationship. It could be that consumers of butter also consume a range of other dairy products.”

“Understanding the true relationship between diet and our health is difficult, but we know that replacing saturated fat with unsaturated fats seems to have a positive impact on our heart health and this is recognised by the authors of this study.

“Whilst the findings of this review indicate a small or neutral association between butter consumption and increased cardiovascular risk, it does not give us the green light to start eating more butter. More investigations are needed into the effects of saturated fat.

“What we do know is fat is just one element of our diet. There are many factors which cause cardiovascular disease and no single food or nutrient is solely responsible for this. To protect your heart health we would recommend a balanced Mediterranean style diet rich in fruit, vegetables and pulses.”

* ‘Is butter back? A systematic review and meta-analysis of butter consumption and risk of cardiovascular disease, diabetes, and total mortality’ by Laura Pimpin et al. will be published in PLOS ONE on Wednesday 29 June 2016.

Declared interests

Prof Tom Sanders: “Prof Tom Sanders is a Scientific Governor of the charity British Nutrition Foundation, member of the scientific advisory committee of the Natural Hydration Council (which promotes the drinking of water), and honorary Nutritional Director of the charity HEART UK. Prof. Tom Sanders is now emeritus but when he was doing research at King’s College London, the following applied: Tom does not hold any grants or have any consultancies with companies involved in the production or marketing of sugar-sweetened drinks. In reference to previous funding to Tom’s institution: £4.5 million was donated to King’s College London by Tate & Lyle in 2006; this funding finished in 2011. This money was given to the College and was in recognition of the discovery of the artificial sweetener sucralose by Prof. Hough at the Queen Elizabeth College (QEC), which merged with King’s College London. The Tate & Lyle grant paid for the Clinical Research Centre at St Thomas’ that is run by the Guy’s & St Thomas’ Trust, it was not used to fund research on sugar. Tate & Lyle sold their sugar interests to American Sugar so the brand Tate & Lyle still exists but it is no longer linked to the company Tate & Lyle PLC, which gave the money to King’s College London in 2006. Tom also used to work for Ajinomoto on aspartame about 8 years ago. Tom was a member of the FAO/WHO Joint Expert Committee that recommended that trans fatty acids be removed from the human food chain. Tom has previously acted as a member of the Global Dairy Platform Scientific Advisory Panel and Tom is a member of the Programme Advisory Committee of the Malaysian Palm Oil Board. In the past Tom has acted as a consultant to Archer Daniel Midland Company and received honoraria for meetings sponsored by Unilever PLC. Tom’s research on fats was funded by Public Health England/Food Standards Agency.”

Prof Pete Wilde: “I don’t think I have any relevant interests to declare. I am employed by the Institute of Food Research, member of the Royal Society of Chemistry, and treasurer of its Food Group committee. My funding comes mainly from the BBSRC, and other governmental sources. I do have a small amount of industry funding, but nothing to do with dairy products, and concerns sensory aspects of food structures and not with nutrition and health. I have no position outside of the IFR with any decision making or policy changing powers. I am an honorary Professor at the University of East Anglia (School of Pharmacy).”

JAMA published “Prevalence of Inappropriate Antibiotic Prescriptions Among US Ambulatory Care Visits, 2010-2011” led by Katherine Fleming-Dutra, MD, estimated portions of antibiotic use that may be inappropriate in adults and children in the United States. – See more at: http://www.ajmc.com/newsroom/understanding-inappropriate-prescribing-of-antibiotics#sthash.lYnWSCqB.dpuf This study found “During 2010-2011, there were 506 annual antibiotic prescriptions per every 1000 population, but only 353 were likely appropriate.” Further, the study found:

Findings
The researchers used 2 annual surveys in 2010 and 2011 to collect data about patients’ demographic characteristics and symptoms, physicians’ diagnoses, and medications ordered, including antibiotics. They found that out of the 184,032 visits, 12.6% of encounters were associated with antibiotic prescriptions. Furthermore, 30% of outpatient prescriptions were in fact unnecessary and inappropriate.

The authors recommend development of diagnostic tests that can distinguish viral infections from bacterial infections in order to improve outpatient antibiotic use.

They used the 2010-2011 National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS) to collect data on patient demographics. Per 1000 population, the diagnosis that was associated with the most antibiotic prescriptions was sinusitis (56 antibiotic prescriptions), followed by suppurative otitis media (47), and pharyngitis (43). Collectively, acute respiratory conditions per 1000 population led to 221 antibiotic prescriptions each year but only 111 of these were actually appropriate for these conditions.

In general, across all ages and conditions, per 1000 population, an estimated 506 antibiotic prescriptions were written annually. And out of these, only 353 antibiotic prescriptions were estimated to be appropriate.

Spillage of Unnecessary Antibiotic Prescriptions
National guidelines state that patients with bronchitis, bronchiolitis, viral upper respiratory tract infections, asthma and allergy, influenza, and viral pneumonia should not receive antibiotics. Antibiotics prescribed for these conditions are considered inappropriate. And yet the study highlighted staggering numbers of inappropriate antibiotic prescriptions.

In an accompanying editorial, Pranita D. Tamma, MD, MHS, and Sara E. Cosgrove, MD, MS, wrote that the estimates in the Fleming-Dutra’s study were likely conservative, but they serve as a good starting point to understanding prescribing practices in the ambulatory care setting.

“Now that baseline estimates about outpatient antibiotic prescribing have been determined, future work needs to focus on interventions targeting both clinicians and patients to help reach the national goal,” wrote Pranita D. Tamma, MD, MHS, and Sara E. Cosgrove, MD, MS, and an accompanying editorial. “It will be critical to continue to evaluate progress in improving antibiotic use in conjunction with widespread adoption of antibiotic stewardship activities in the outpatient setting.” – See more at: http://www.ajmc.com/newsroom/understanding-inappropriate-prescribing-of-antibiotics#sthash.lYnWSCqB.dpuf

The practice of over-prescribing antibiotics has serious consequences.

Science Daily reported in Study investigates whether it is safe for GPs to prescribe fewer antibiotics:

A new study has found that reducing antibiotic prescribing for respiratory tract infections — such as coughs, colds, sore throats and ear infections — is not linked to an increase in the most serious bacterial complications, such as bacterial meningitis. The study, published in the BMJ, investigated whether reducing antibiotic prescribing for people attending their GP with respiratory tract infections could have an effect on safety.

Most respiratory tract infections are caused by viruses and will improve without treatment. Antibiotic treatment has minimal effect on the duration and severity of symptoms in these conditions, but may be associated with side-effects.

The widespread inappropriate use of antibiotics is contributing to the development of strains of bacteria that are resistant to antibiotics.

This study, funded by the NIHR and led by researchers from King’s College London, analysed patient records from 610 UK general practices, with more than four million patients, over 10 years. General practices with lower rates of antibiotic prescribing for respiratory tract infections did not have higher rates of serious bacterial complications, including: meningitis, mastoiditis (infection of the mastoid bone behind the ear), empyema (infection of the lining of the lungs), brain abscess or Lemierre’s syndrome (an infection of the jugular vein in the neck).

The research found that practices that prescribed fewer antibiotics had slightly higher rates of pneumonia and peritonsillar abscess (also known as quinsy) — a rare complication of sore throats. Both of these conditions are treatable with antibiotics once identified.

The researchers estimated that if an average-sized GP practice with 7,000 patients reduced its antibiotic prescribing to people with respiratory tract infections by 10 per cent, there could be one extra case of pneumonia each year. They also estimated that this reduced prescribing could be linked to one extra case of peritonsillar abscess every 10 years.

The authors observe that reducing antibiotic use is likely to reduce the number of people experiencing side-effects. About 10 per cent of people who take antibiotics experience common side-effects such as rashes, diarrhea and vomiting, while rare side-effects include anaphylaxis….https://www.sciencedaily.com/releases/2016/07/160704223418.htm

Citation:

Study investigates whether it is safe for GPs to prescribe fewer antibiotics

Date: July 4, 2016

Source: King’s College London

Summary:

A new study has found that reducing antibiotic prescribing for respiratory tract infections — such as coughs, colds, sore throats and ear infections — is not linked to an increase in the most serious bacterial complications, such as bacterial meningitis. The study investigated whether reducing antibiotic prescribing for people attending their GP with respiratory tract infections could have an effect on safety.

A new study has found that reducing antibiotic prescribing for respiratory tract infections – such as coughs, colds, sore throats and ear infections – is not linked to an increase in the most serious bacterial complications, such as bacterial meningitis.

The study, published in the BMJ, investigated whether reducing antibiotic prescribing for people attending their GP with respiratory tract infections could have an effect on safety.

Most respiratory tract infections are caused by viruses and will improve without treatment. Antibiotic treatment has minimal effect on the duration and severity of symptoms in these conditions, but may be associated with side-effects.

The widespread inappropriate use of antibiotics is contributing to the development of strains of bacteria that are resistant to antibiotics.

This study, funded by the NIHR and led by researchers from King’s College London, analysed patient records from 610 UK general practices, with more than four million patients, over 10 years. General practices with lower rates of antibiotic prescribing for respiratory tract infections did not have higher rates of serious bacterial complications, including: meningitis, mastoiditis (infection of the mastoid bone behind the ear), empyema (infection of the lining of the lungs), brain abscess or Lemierre’s syndrome (an infection of the jugular vein in the neck).

The research found that practices that prescribed fewer antibiotics had slightly higher rates of pneumonia and peritonsillar abscess (also known as quinsy) – a rare complication of sore throats. Both of these conditions are treatable with antibiotics once identified.

The researchers estimated that if an average-sized GP practice with 7,000 patients reduced its antibiotic prescribing to people with respiratory tract infections by 10 per cent, there could be one extra case of pneumonia each year. They also estimated that this reduced prescribing could be linked to one extra case of peritonsillar abscess every 10 years.

The authors observe that reducing antibiotic use is likely to reduce the number of people experiencing side-effects. About 10 per cent of people who take antibiotics experience common side-effects such as rashes, diarrhoea and vomiting, while rare side-effects include anaphylaxis.

Professor Martin Gulliford, lead author from the Division of Health and Social Care Research at King’s College London, said: ‘Overuse of antibiotics now may result in increasing infections by resistant bacteria in the future. Current treatment recommendations are to avoid antibiotics for self-limiting respiratory infections. Our results suggest that, if antibiotics are not taken, this should carry no increased risk of more serious complications. General practices prescribing fewer antibiotics may have slightly higher rates of pneumonia and peritonsillar abscess but even a substantial reduction in antibiotic prescribing may be associated with only a small increase in the numbers of cases observed. Both these complications can be readily treated once identified.’

Dr Mark Ashworth, GP and author of the study from the King’s Division of Health and Social Care Research, said: ‘As a practicing GP, I see very few complications from patients who have upper respiratory tract infections and who decide to opt for a non-antibiotic approach to treating their infections. Patients are recognising that most upper respiratory infections are viral and virus infections do not respond to antibiotics. Our paper should reassure GPs and patients that rare bacterial complications of respiratory infections are indeed rare. Fortunately, if there are any signs of a complication, the GP can quickly step in and offer an appropriate antibiotic.’

The authors caution that the results represent averages across general practice populations; this study did not evaluate the outcome of prescribing decisions for individual patients.

Notes to editors:

For more information, please contact the King’s College London press office on 020 7848 3202, pr@kcl.ac.uk.

‘Safety of reduced antibiotic prescribing for self-limiting respiratory tract infections in primary care: Cohort study using electronic health records’ by Gulliford et al is published in the British Medical Journal on Tuesday 5 July 2016. doi: 10.1136/bmj.i3410

The study was funded by the NIHR Health Technology Assessment programme. Study authors were supported by the NIHR Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London.

About the NIHR

The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. The NIHR is the research arm of the NHS. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government’s strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website (www.nihr.ac.uk).

In many cases antibiotic use may not be appropriate.

FamilyDoctor.org offers the following advice:

How do I know when I need antibiotics?

The answer depends on what is causing your infection. The following are some basic guidelines:

Colds and flu. Viruses cause these illnesses. They can’t be cured with antibiotics.

Cough or bronchitis. Viruses almost always cause these. However, if you have a problem with your lungs or an illness that lasts a long time, bacteria may actually be the cause. Your doctor may decide to try using an antibiotic.

Sore throat. Most sore throats are caused by viruses and don’t need antibiotics. However, strep throat is caused by bacteria. Your doctor can determine if you have strep throat and can prescribe an antibiotic.

Ear infections. There are several types of ear infections. Antibiotics are used for some (but not all) ear infections.

What else do I need to know?

If your doctor does prescribe an antibiotic for you, make sure you take all of the medicine, even if you feel better after a few days. This reduces the chance that there will be any bacteria left in your body that could potentially become resistant to antibiotics.

Never take antibiotics without a prescription. If, for whatever reason, you have antibiotics leftover from a time when you were previously sick, do not take them unless your doctor tells you it’s okay. The leftover antibiotics may not work on whatever is making you sick. If they do work, there probably will not be enough leftover medicine to completely kill all the bacteria in your body. Not only will you not get better, but this increases the chance that the bacteria will become resistant to antibiotics.

The number of children with autism appears to be growing. The Centers for Disease Control and Prevention provides statistics on the number of children with autism in the section Data and Statistics:

Prevalence

It is estimated that between 1 in 80 and 1 in 240 with an average of 1 in 110 children in the United States have an ASD. [Read article]

ASDs are reported to occur in all racial, ethnic, and socioeconomic groups, yet are on average 4 to 5 times more likely to occur in boys than in girls. However, we need more information on some less studied populations and regions around the world. [Read article]

Studies in Asia, Europe, and North America have identified individuals with an ASD with an approximate prevalence of 0.6% to over 1%. A recent study in South Korea reported a prevalence of 2.6%. [Data table ]

Approximately 13% of children have a developmental disability, ranging from mild disabilities such as speech and language impairments to serious developmental disabilities, such as intellectual disabilities, cerebral palsy, and autism. [Read article] http://www.cdc.gov/ncbddd/autism/data.html

In order for children with autism to reach their full potential there must be early diagnosis and treatment.

A new study has found that paracetamol (acetaminophen), which is used extensively during pregnancy, has a strong association with autism spectrum symptoms in boys and for both genders in relation to attention-related and hyperactivity symptoms.

The findings were published this week in the International Journal of Epidemiology. This is the first study of its kind to report an independent association between the use of this drug in pregnancy and autism spectrum symptoms in children. It is also the first study to report different effects on boys and girls. Comparing persistently to nonexposed children, the study has found an increase of 30 per cent in the risk of detriment to some attention functions, and an increase of two clinical symptoms of autism spectrum symptoms in boys.

Researchers in Spain recruited 2644 mother-child pairs in a birth cohort study during pregnancy. 88 per cent were evaluated when the child was one year old, and 79.9 per cent were evaluated when they were five years old. Mothers were asked about their use of paracetamol during pregnancy and the frequency of use was classified as never, sporadic, or persistent. Exact doses could not be noted due to mothers being unable to recall them exactly.

43 per cent of children evaluated at age one and 41 per cent assessed at age five were exposed to any paracetamol at some point during the first 32 weeks of pregnancy. When assessed at age five, exposed children were at higher risk of hyperactivity or impulsivity symptoms. Persistently exposed children in particular showed poorer performance on a computerised test measuring inattention, impulsivity and visual speed processing.

Boys also showed more autism spectrum symptoms when persistently exposed to paracetamol. Lead author Claudia Avella-Garcia, researcher at CREAL, an ISGlobal allied centre in Barcelona, explained that, “although we measured symptoms and not diagnoses, an increase in the number of symptoms that a child has, can affect him or her, even if they are not severe enough to warrant a clinical diagnosis of a neurodevelopmental disorder…”

There could also be an explanation for why boys are more likely to have autism spectrum symptoms: “The male brain may be more vulnerable to harmful influences during early life,” said Claudia Avella-Garcia. “Our differing gender results suggest that androgenic endocrine disruption, to which male brains could be more sensitive, may explain the association.”

The study concluded that the widespread exposure of infants to paracetamol in utero could increase the number of children with ADHD or autism spectrum symptoms. However, they stressed further studies should be conducted with more precise dosage measurements, and that the risks versus benefits of paracetamol use during pregnancy and early life should be assessed before treatment recommendations are made. https://www.sciencedaily.com/releases/2016/07/160701095445.htm

Citation:

Prenatal exposure to acetaminophen may increase autism spectrum and hyperactivity symptoms in children

Date: July 1, 2016

Source: Oxford University Press (OUP)

Summary:

A new study has found that paracetamol (acetaminophen), which is used extensively during pregnancy, has a strong association with autism spectrum symptoms in boys and for both genders in relation to attention-related and hyperactivity symptoms.

Abstract

Background: Acetaminophen is extensively used during pregnancy. But there is a lack of population-representative cohort studies evaluating its effects on a range of neuropsychological and behavioural endpoints. We aimed to assess whether prenatal exposure to acetaminophen is adversely associated with neurodevelopmental outcomes at 1 and 5 years of age.

Methods: This Spanish birth cohort study included 2644 mother-child pairs recruited during pregnancy. The proportion of liveborn participants evaluated at 1 and 5 years was 88.8% and 79.9%, respectively. Use of acetaminophen was evaluated prospectively in two structured interviews. Ever/never use and frequency of use (never, sporadic, persistent) were measured. Main neurodevelopment outcomes were assessed using Childhood Autism Spectrum Test (CAST), Conner’s Kiddie Continuous Performance Test (K-CPT) and ADHD-DSM-IV form list. Regression models were adjusted for social determinants and co-morbidities.

Conclusions: Prenatal acetaminophen exposure was associated with a greater number of autism spectrum symptoms in males and showed adverse effects on attention-related outcomes for both genders. These associations seem to be dependent on the frequency of exposure.

One of the implications of this study is the necessity that women receive adequate prenatal care and women really should have pre-pregnancy counseling and care.

Prenatal care is a critical component of health care for pregnant women and a key step towards having a healthy pregnancy and baby. Early prenatal care is especially important because many important developments take place during the first trimester, screenings can identify babies or mothers at risk for complications and health care providers can educate and prepare mothers for pregnancy. Women who receive prenatal care have consistently shown better outcomes than those who did not receive prenatal care[1]. Mothers who do not receive any prenatal care are three times more likely to deliver a low birth weight baby than mothers who received prenatal care, and infant mortality is five times higher[2]. Early prenatal care also allows health care providers to identify and address health conditions and behaviors that may reduce the likelihood of a healthy birth, such as smoking and drug and alcohol abuse. http://www.americashealthrankings.org/All/PrenatalCare/2012

Given this recent study it is imperative that ALL women receive prenatal care particularly poor and those women at risk of difficult pregnancies.